Cholesterol + CHD Flashcards
What has the Framingham study shown?
Correlation between total serum cholesterol and CHD incidence
How do oxidised LDL’s promote atherogenesis?
- Inhibit macrophage motility
- Induce T-cell activation
- Toxic to endothelial cells
- Enhances platelet aggregation
What has the Seven Countries Study found?
Significant correlation between total serum cholesterol and deaths from CHD in Northern Europe and the US, but not in Southern Europe ands Japan
What is the target total cholesterol level?
< 5 mmol/L
What is the indications for starting a patient on a statin?
- If QRISK2 score is 10% or more
- Type 1 diabetics
- CKD
- Familial hypercholesterolaemia
What does the QRISK2 score show?
A persons risk of developing CVD over the next 10 years
At what QRISK2 score would you consider starting the patient on a statin?
10% or more
What is the mechanism of action of statins?
- Inhibit HMG-CoA reductase = inhibit the formation of cholesterol in the liver
- ^synthesis of LDL receptors = ^clearance of LDL + VLDL
What is the first-line lipid modification treatment which should be offered for primary prevention of CVD?
Atorvastatin 20mg OD
List some side effects of statins:
- Myalgia
- Myopathy
- Rhabdomyolysis
- GI disturbances
- Headache
- Pruritus
- Rash
- Arthralgia
- Fatigue
- Hepatitis
List some common or very common side effects of Atorvastatin:
- Back pain
- Epistaxis
- Hyperglycaemia
- Nasopharyngitis
- Pharyngeolaryngeal pain
Myopathy is often seen when statins are combined with which other drugs/supplements?
- Ciclosporin
- Gemfibrozil
- Erythromycin
- Niacin
